Provider Demographics
NPI:1114900651
Name:EASTVIEW VISION INC
Entity Type:Organization
Organization Name:EASTVIEW VISION INC
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-394-1128
Mailing Address - Street 1:PO BOX 162
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-0162
Mailing Address - Country:US
Mailing Address - Phone:585-394-1128
Mailing Address - Fax:585-394-6877
Practice Address - Street 1:6081 ROUTE 96 S
Practice Address - Street 2:STE 8
Practice Address - City:FARMINGTON
Practice Address - State:NY
Practice Address - Zip Code:14425
Practice Address - Country:US
Practice Address - Phone:585-924-2550
Practice Address - Fax:585-924-4399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8786OtherBLUE CROSS BLUE SHIELD
NY0887020001Medicare ID - Type Unspecified